Ccessing antiretroviral therapy (ART) [3]. Among PLWHA, depressive disorder is the commonest neuropsychiatric disorder, occurring at rates two to three times higher than in HIV-negative patients [4?]. The prevalence of depressive disorder among PLWHA in Uganda has been reported as 20?0 [7?0]. Depressive disorder in PLWHA has been associated with several critical adverse health- N-related peptides and their receptors elicit profound scratching like morphine in related outcomes. Previous work has documented poor adherence to medications, including ART in depressed PLWHA [11?3]. Other researchers have also documented that PLWHA suffering from depression progress faster from HIV to AIDS compared to non-depressed PLWHA [14?7]. Compared to depressed HIV negative persons,PLWHA who suffer from depression have also been shown to have a poor quality of life [18]. The development of depressive disorder among PLWHA is likely the result of a combination of biological and sociodemographic variables [14,19?2]. Some of these biological variables may be relatively unique to PLWHA, such as AIDS-related Title Loaded From File stigma [20,21], compromised immune status (low CD4 counts) and increased opportunistic infections [19,23,24]. However, sociodemographic variables including gender, low education and lack of employment have been associated with depression in both HIV negative and positive populations [22,25,26] AIDS- related stigma is prominent among PLWHA and has been shown to negatively impact on the quality of life, leading to poor functioning of affected individuals [27,28]. Research has also shown that PLWHA who have stigma are less likely to access HIV care services [27,29,30],and could have poor psychological wellbeing [21,31]. Some work done in South Africa has documented increased burden of AIDS stigma and its association with mental disorders [20,32]. Despite its prominence, AIDS related stigma among PLWHA is often unidentified [28,30,32,33].Aids, Stigma, Depressive Disorder, UgandaThe dual existence of AIDS related stigma and major depressive disorder among PLWHA could lead to a number of adverse health outcomes. However, little work has been done to particularly assess the association between AIDS related stigma and major depressive disorder in sub-Saharan Africa [20,32,33]. Examining the relationship between AIDS related stigma and major depressive could prove useful in raising clinician’s awareness about the need to holistically assess PLWHA who present at PHC. Similarly, literature about the other factors that may be associated with major depressive disorder, including immunological and sociodemographic variables in PLWHA is less consistent. Thus while some work has reported that a low CD4 count is associated with having depression in PLWHA [15,17], other researchers have found otherwise [22,34]. Research findings about the association between major depressive disorder and female gender [22,35], being of younger age [35?7] and unemployment [37] have equally shown inconsistencies. Examining the association between depression and these factors is important since some of them have been shown to influence health outcomes in PLWHA [15,19,22]. In this study, we investigated the extent to which major depressive disorder was associated with AIDS-related stigma, and a number of other variables in PLWHA with the aim of making recommendations that can guide clinicians.Ethical approvalThe study was approved by the Makerere University School of Medicine Ethics 12926553 committee and the University of Cape Town Health Sciences Human Research Ethics Committees. S.Ccessing antiretroviral therapy (ART) [3]. Among PLWHA, depressive disorder is the commonest neuropsychiatric disorder, occurring at rates two to three times higher than in HIV-negative patients [4?]. The prevalence of depressive disorder among PLWHA in Uganda has been reported as 20?0 [7?0]. Depressive disorder in PLWHA has been associated with several critical adverse health- related outcomes. Previous work has documented poor adherence to medications, including ART in depressed PLWHA [11?3]. Other researchers have also documented that PLWHA suffering from depression progress faster from HIV to AIDS compared to non-depressed PLWHA [14?7]. Compared to depressed HIV negative persons,PLWHA who suffer from depression have also been shown to have a poor quality of life [18]. The development of depressive disorder among PLWHA is likely the result of a combination of biological and sociodemographic variables [14,19?2]. Some of these biological variables may be relatively unique to PLWHA, such as AIDS-related stigma [20,21], compromised immune status (low CD4 counts) and increased opportunistic infections [19,23,24]. However, sociodemographic variables including gender, low education and lack of employment have been associated with depression in both HIV negative and positive populations [22,25,26] AIDS- related stigma is prominent among PLWHA and has been shown to negatively impact on the quality of life, leading to poor functioning of affected individuals [27,28]. Research has also shown that PLWHA who have stigma are less likely to access HIV care services [27,29,30],and could have poor psychological wellbeing [21,31]. Some work done in South Africa has documented increased burden of AIDS stigma and its association with mental disorders [20,32]. Despite its prominence, AIDS related stigma among PLWHA is often unidentified [28,30,32,33].Aids, Stigma, Depressive Disorder, UgandaThe dual existence of AIDS related stigma and major depressive disorder among PLWHA could lead to a number of adverse health outcomes. However, little work has been done to particularly assess the association between AIDS related stigma and major depressive disorder in sub-Saharan Africa [20,32,33]. Examining the relationship between AIDS related stigma and major depressive could prove useful in raising clinician’s awareness about the need to holistically assess PLWHA who present at PHC. Similarly, literature about the other factors that may be associated with major depressive disorder, including immunological and sociodemographic variables in PLWHA is less consistent. Thus while some work has reported that a low CD4 count is associated with having depression in PLWHA [15,17], other researchers have found otherwise [22,34]. Research findings about the association between major depressive disorder and female gender [22,35], being of younger age [35?7] and unemployment [37] have equally shown inconsistencies. Examining the association between depression and these factors is important since some of them have been shown to influence health outcomes in PLWHA [15,19,22]. In this study, we investigated the extent to which major depressive disorder was associated with AIDS-related stigma, and a number of other variables in PLWHA with the aim of making recommendations that can guide clinicians.Ethical approvalThe study was approved by the Makerere University School of Medicine Ethics 12926553 committee and the University of Cape Town Health Sciences Human Research Ethics Committees. S.
